Functional Improvements Utilizing the Short Physical Performance Battery (SPPB) in the Elderly after Epidural Steroid Injections

Rene Przkora, Michael Kinsky, Steven Fisher, Christopher Babl, Christoph E. Heyde, Terrie Vasilopoulos, Alan D. Kaye, Elena Volpi

Research output: Contribution to journalReview article

Abstract

Purpose of Review: The treatment of debilitating pain and loss of function secondary to lumbar stenosis is in high demand with the aging patient population. Options, including epidural steroid injections (ESIs) and medication therapy, are limited and it is unclear if they provide any functional improvements. In this prospective study, we evaluate functional outcomes in older adults with symptomatic lumbar stenosis treated with ESIs compared to those managed with medications by introducing the Short Physical Performance Battery (SPPB). Our study was IRB-approved and included 16 patients, 68 to 83 years old, with symptomatic back and radicular leg pain secondary to lumbar stenosis. Patients could elect to undergo a lumbar ESI (n = 11) or be treated via medication management (n = 5). Numeric pain score, SPPB score, and adverse events were measured and compared at baseline and a 1-month follow-up visit. Recent Findings: Statistically significant improvements were observed from baseline compared to the 1-month follow-up for total SPPB score in the injection group. Similar improvements in the injection group were observed for pain scores and the SPPB subcomponents such as the 4-m walk test, chair stand time, and balance score. Comparatively, no statistically significant improvements were observed in the medication group. Summary: Lumbar ESIs improved objective physical capacity parameters and pain scores in elderly patients with symptomatic lumbar stenosis compared to medication management. In addition, the SPPB is an easy-to-use tool to measure changes in physical function in older adults and could easily be integrated into an outpatient pain clinic.

Original languageEnglish (US)
Article number14
JournalCurrent Pain and Headache Reports
Volume23
Issue number2
DOIs
StatePublished - Feb 1 2019

Fingerprint

Epidural Injections
Steroids
Pathologic Constriction
Pain
Pain Clinics
Injections
Research Ethics Committees
Ambulatory Care Facilities
Leg
Prospective Studies
Therapeutics
Population

Keywords

  • Elderly
  • Epidural steroid injections
  • Lumbar stenosis and radicular pain
  • Short physical performance battery (SPPB)

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Functional Improvements Utilizing the Short Physical Performance Battery (SPPB) in the Elderly after Epidural Steroid Injections. / Przkora, Rene; Kinsky, Michael; Fisher, Steven; Babl, Christopher; Heyde, Christoph E.; Vasilopoulos, Terrie; Kaye, Alan D.; Volpi, Elena.

In: Current Pain and Headache Reports, Vol. 23, No. 2, 14, 01.02.2019.

Research output: Contribution to journalReview article

@article{4746321ef2164c31b6ed6e4d37cf1be5,
title = "Functional Improvements Utilizing the Short Physical Performance Battery (SPPB) in the Elderly after Epidural Steroid Injections",
abstract = "Purpose of Review: The treatment of debilitating pain and loss of function secondary to lumbar stenosis is in high demand with the aging patient population. Options, including epidural steroid injections (ESIs) and medication therapy, are limited and it is unclear if they provide any functional improvements. In this prospective study, we evaluate functional outcomes in older adults with symptomatic lumbar stenosis treated with ESIs compared to those managed with medications by introducing the Short Physical Performance Battery (SPPB). Our study was IRB-approved and included 16 patients, 68 to 83 years old, with symptomatic back and radicular leg pain secondary to lumbar stenosis. Patients could elect to undergo a lumbar ESI (n = 11) or be treated via medication management (n = 5). Numeric pain score, SPPB score, and adverse events were measured and compared at baseline and a 1-month follow-up visit. Recent Findings: Statistically significant improvements were observed from baseline compared to the 1-month follow-up for total SPPB score in the injection group. Similar improvements in the injection group were observed for pain scores and the SPPB subcomponents such as the 4-m walk test, chair stand time, and balance score. Comparatively, no statistically significant improvements were observed in the medication group. Summary: Lumbar ESIs improved objective physical capacity parameters and pain scores in elderly patients with symptomatic lumbar stenosis compared to medication management. In addition, the SPPB is an easy-to-use tool to measure changes in physical function in older adults and could easily be integrated into an outpatient pain clinic.",
keywords = "Elderly, Epidural steroid injections, Lumbar stenosis and radicular pain, Short physical performance battery (SPPB)",
author = "Rene Przkora and Michael Kinsky and Steven Fisher and Christopher Babl and Heyde, {Christoph E.} and Terrie Vasilopoulos and Kaye, {Alan D.} and Elena Volpi",
year = "2019",
month = "2",
day = "1",
doi = "10.1007/s11916-019-0748-2",
language = "English (US)",
volume = "23",
journal = "Current Pain and Headache Reports",
issn = "1531-3433",
publisher = "Current Science, Inc.",
number = "2",

}

TY - JOUR

T1 - Functional Improvements Utilizing the Short Physical Performance Battery (SPPB) in the Elderly after Epidural Steroid Injections

AU - Przkora, Rene

AU - Kinsky, Michael

AU - Fisher, Steven

AU - Babl, Christopher

AU - Heyde, Christoph E.

AU - Vasilopoulos, Terrie

AU - Kaye, Alan D.

AU - Volpi, Elena

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Purpose of Review: The treatment of debilitating pain and loss of function secondary to lumbar stenosis is in high demand with the aging patient population. Options, including epidural steroid injections (ESIs) and medication therapy, are limited and it is unclear if they provide any functional improvements. In this prospective study, we evaluate functional outcomes in older adults with symptomatic lumbar stenosis treated with ESIs compared to those managed with medications by introducing the Short Physical Performance Battery (SPPB). Our study was IRB-approved and included 16 patients, 68 to 83 years old, with symptomatic back and radicular leg pain secondary to lumbar stenosis. Patients could elect to undergo a lumbar ESI (n = 11) or be treated via medication management (n = 5). Numeric pain score, SPPB score, and adverse events were measured and compared at baseline and a 1-month follow-up visit. Recent Findings: Statistically significant improvements were observed from baseline compared to the 1-month follow-up for total SPPB score in the injection group. Similar improvements in the injection group were observed for pain scores and the SPPB subcomponents such as the 4-m walk test, chair stand time, and balance score. Comparatively, no statistically significant improvements were observed in the medication group. Summary: Lumbar ESIs improved objective physical capacity parameters and pain scores in elderly patients with symptomatic lumbar stenosis compared to medication management. In addition, the SPPB is an easy-to-use tool to measure changes in physical function in older adults and could easily be integrated into an outpatient pain clinic.

AB - Purpose of Review: The treatment of debilitating pain and loss of function secondary to lumbar stenosis is in high demand with the aging patient population. Options, including epidural steroid injections (ESIs) and medication therapy, are limited and it is unclear if they provide any functional improvements. In this prospective study, we evaluate functional outcomes in older adults with symptomatic lumbar stenosis treated with ESIs compared to those managed with medications by introducing the Short Physical Performance Battery (SPPB). Our study was IRB-approved and included 16 patients, 68 to 83 years old, with symptomatic back and radicular leg pain secondary to lumbar stenosis. Patients could elect to undergo a lumbar ESI (n = 11) or be treated via medication management (n = 5). Numeric pain score, SPPB score, and adverse events were measured and compared at baseline and a 1-month follow-up visit. Recent Findings: Statistically significant improvements were observed from baseline compared to the 1-month follow-up for total SPPB score in the injection group. Similar improvements in the injection group were observed for pain scores and the SPPB subcomponents such as the 4-m walk test, chair stand time, and balance score. Comparatively, no statistically significant improvements were observed in the medication group. Summary: Lumbar ESIs improved objective physical capacity parameters and pain scores in elderly patients with symptomatic lumbar stenosis compared to medication management. In addition, the SPPB is an easy-to-use tool to measure changes in physical function in older adults and could easily be integrated into an outpatient pain clinic.

KW - Elderly

KW - Epidural steroid injections

KW - Lumbar stenosis and radicular pain

KW - Short physical performance battery (SPPB)

UR - http://www.scopus.com/inward/record.url?scp=85061916393&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061916393&partnerID=8YFLogxK

U2 - 10.1007/s11916-019-0748-2

DO - 10.1007/s11916-019-0748-2

M3 - Review article

C2 - 30796532

AN - SCOPUS:85061916393

VL - 23

JO - Current Pain and Headache Reports

JF - Current Pain and Headache Reports

SN - 1531-3433

IS - 2

M1 - 14

ER -